Individual
RAVIKIRAN IYENGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
817 RAHWAY AVE, ELIZABETH, NJ 07202-2212
(908) 353-5750
Mailing address
817 RAHWAY AVE, ELIZABETH, NJ 07202-2212
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00301100
NJ
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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